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Pressure mapping systems: an undervalued and underutilized assessment tool

As therapists, we use tools to assist us during the initial evaluation and subsequent treatment sessions. For example, if you are a sensory integration therapist, you might have playdough, brushes, and swings in your toolbox. Wheelchair seating and positioning is no different. One tool, that is very helpful when performing wheeled seating interventions is a pressure mapping system.

When should I consider an alternative drive control?

This is the 2nd blog in our series on alternative drive controls. Check out the 1st blog here. Check out the Power Wheelchair Guide for more information on power mobility, and The Wheelchair Handbook: A Consumer’s Guide to Seating and Mobility Equipment for more information on the wheelchair provision process.

When determining whether an alternative drive control is needed, it is important first to consider the following with a standard joystick:

Positioning of the individual – Have you optimized positioning for support while allowing for freedom of movement and use of available range of motion/strength?
Mounting/placement of the joystick – Consider the location and height of the joystick. Sometimes a half inch lower, or slightly inward of the armrest can mean the difference between success and failure.
Alternative joystick knobs – There are a variety of joystick knobs that fit on a standard joystick and provide different shapes, textures, and heights based on the individual’s unique hand and/or arm function.
Programming adjustments – In addition to programming the chair’s speeds, programming adjustments can be made to impact how the joystick responds to the individual’s movements (throw, tremor dampening, deadband, etc.).
Access to additional wheelchair functionality – Access to power seat functions, mode, and powering the chair on/off are important for maximizing the chair functionality and the individual’s independence.

Once a standard joystick has been trialed with these considerations without success, the use of an alternative drive control may be evaluated. When considering alternative drive control options, it is important to keep the following in mind:

Maximize positioning and stability needs before beginning.
Identify where there is movement and where the movement is most consistent – start there.
Evaluate how much movement is available. Ask how much range of motion is required to effectively operate the alternative drive control being considered. Do different positions of the drive control elicit more or less access and consistency?
Evaluate how much strength is available. Ask how much strength is required to deflect the chosen proportional input device or how much strength is required to activate the switched/non-proprtional input device.
Consider access to seat functions, other modes such as Bluetooth, as well as power on/off.
Consider additional factors like the cognitive demands of the drive control and the visual perceptual abilities of the individual.
Is fatigue a factor? Does the individual have enough endurance for the chosen drive control?
Some clients with fatigue can use a standard joystick part of the day, and require an alternative drive control for part of the day.
If your client has a progressive disorder, consider potential future alternative drive control needs/options and discuss with their equipment provider. Depending on how quickly you or your client’s condition is progressing, sometimes alternative drive controls are ordered before they are needed.

Join us next time as we review the two main categories of power wheelchair drive controls: 1) proportional, and 2) switched/non-proportional.
Interested in learning more about alternative drive controls and the new options from Permobil? Sign up for our July webinar here.

How do I prepare for getting a power assist device?

This is part of our series highlighting a consumer's guide to seating and mobility equipment. Check out The Wheelchair Handbook for more information about the wheelchair service provision process.

Are you a full-time manual wheelchair user, meaning, you use your wheelchair for your safe, basic and functional mobility? Have you ever thought about adding a Power Assist Device to your manual wheelchair?

This series of blogs will highlight things to think about before you meet with your Team. Each blog will provide you with questions to help you evaluate your own needs and goals, so that you can share this information with your Team.
This is #2 in our series and will highlight Power Assist. In the first blog, you learned about how to prepare for getting a seating system. The next blog in this series will highlight power wheelchairs.

View all blog posts.


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